Lipoma - What Is It And How To Treat It? Symptoms And Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

Lipoma - what is it and how to treat it?

Lipoma - what is it?

A lipoma is a benign growth of adipose tissue that is most often located under the skin, but can also be found in internal organs that have a layer of fat.

Lipoma can be diagnosed at any age, in people of any gender. Most often they are detected in women aged 30-50 years. Outwardly, it looks like a subcutaneous node, which has a soft structure, it is mobile and painless. The knot is not welded to the surrounding tissue. The average size of a lipoma is 2 cm, but sometimes giant neoplasms form in people

Lipoma can be represented not only by adipose tissue, but also by connective tissue. In this case, it has a denser consistency.

There are both single and multiple neoplasms. They can be found on the back, on the shoulders, on the chest, on the legs and on the stomach. In general, any place in the human body that is not deprived of adipose tissue can become the basis for the development of lipoma. They are often found on the scalp covered with hair, on the face, behind the ears.

Lipomas are not malignant, as they are in capsules. Like all other benign tumors, lipomas grow slowly, do not metastasize, and do not grow into other tissues and organs. It is the capsule that makes the growth of the lipoma non-aggressive.

The main areas of the human body where lipomas can form:

• Skin and subcutaneous fatty tissue (subcutaneous lipoma).
• Fatty deposits between muscles (myolipoma).
• The fatty membrane that surrounds the kidneys (angiolipoma).
• Mammary gland.
• Retroperitoneal fat.
• Rib cage.
• Intestines.
• Rare sites of lipoma localization: heart muscle, brain, lungs, nerve trunks (perineural lipoma), bones, sweat glands.

Lipomas can be topical and heterotopic. Topical lipomas are made up of those fat cells that are found in the organ on which they are formed. Heterotopic lipomas are rarely diagnosed, they can form on the uterus, liver and in the cranial cavity. Since there are no fat cells in these organs, lipomas are represented by fat, which accidentally got there during intrauterine development.

Lipomas form in both thin and overweight people. Body weight in this case does not matter. If a person begins to lose weight, this does not in any way affect the neoplasm. Lipoma will continue its slow growth.

Content:

• Lipoma types
• Reasons for the formation of a lipoma
• Lipoma symptoms
• Lipoma diagnostics
• What is the difference between lipoma and atheroma?
• Is lipoma dangerous?
• Lipoma treatment
• Should lipoma be removed?
• Can a lipoma resolve on its own?

Lipoma types

Depending on the histological structure, two types of lipomas are distinguished:

• Knotty. Lipoma is represented by a node enclosed in a capsule. The tumor itself consists of lobules of different sizes. The lobules are represented by fat cells. Most lipomas have a nodular structure.

• Diffuse. These lipomas are rare. They are made up of fat cells and characterize a disease called lipomatosis (systemic damage to adipose tissue).

Depending on whether other cells other than fat cells are present in the lipoma, they distinguish:

• Classic lipoma - consists only of fat cells.
• Fibrolipoma - the tumor is represented by fat cells and connective tissue.
• Myolipoma - A tumor made up of fat cells and muscle tissue.
• Myxolipoma is a neoplasm that contains fat cells and mucus.
• Angiolipoma, in this tumor, in addition to fat cells, there are blood vessels.
• Myelolipoma, in such lipomas, in addition to fat cells, there are bone marrow particles.
• Hibernoma is a tumor represented by brown fat cells.

Depending on the structural features of the tumor, the following types of lipomas are distinguished:

• The cervical annular tumor is represented by multiple lipomas and looks like a kind of necklace located on the neck.
• A capsulated lipoma that forms in a capsule that surrounds an organ.
• A tree-like lipoma, which has growths that resemble a tree crown in appearance. Such lipomas form in the joint cavities.
• Cavernous lipoma, which is penetrated by many vessels.
• Lipoma on the leg. The leg is represented by a flap of skin or connective tissue of the organ on which the tumor is located.

• Soft lipoma, which, in addition to fat cells, contains fluid, such as mucus.
• Dense lipoma, which contains connective tissue.

Reasons for the formation of a lipoma

Experts have identified two mechanisms for the formation of lipomas:

1. Lipoma grows like a tumor. In this case, the fat cells of the neoplasm multiply from one cell, being its clones. Therefore, most lipomas have a lobular structure.
2. Lipoma is formed against the background of a violation of the outflow of the sebaceous glands. In this case, fat cells begin to accumulate in the lumen of the gland. Such lipomas most often come to the surface through the lumen of the sebaceous gland and do not have lobules.

As for the reasons that lead to the formation of lipomas, there are several of them:

• Hereditary predisposition. In this case, we are talking about a disease such as lipomatosis, which is characterized by the formation of many tumors. This pathology is inherited in an autosomal dominant manner and manifests itself in youth, regardless of the sex of the child.

• Fat metabolism disorders. Fat metabolism disorders that lead to the formation of lipomas do not depend on what physique the person is. He can be either thin or fat. In this case, there is an increase in the blood of low density lipoproteins. Such fats cannot freely pass through the walls of blood vessels and clog them. If this process progresses, the person develops a disease called atherosclerosis. In this case, atherosclerotic plaques form on the vessels, and the liver suffers from fatty hepatosis. In narrow capillaries, fat deposits become so intense that this leads to a blockage of their lumen. Gradually, fatty deposits in these places begin to grow, a capsule is formed around them, which has multiple septa, thus lipomas are formed.

  Risk factors leading to an increase in low-density lipoproteins in the blood: physical inactivity, the predominance of animal fats in the menu, genetic diseases. It should be noted that doctors call lipomas practically the only visible markers that can prompt a person to think about high blood cholesterol levels and consult a doctor.

• Failure in the regulation of fat metabolism. A well-coordinated mechanism is responsible for the distribution of fat in the body. It removes excess fats from food, regulates the accumulation of fat in different places depending on the sex of the person, etc. In general, this mechanism is automatically regulated by the body and does not require hormonal or any other control.

  However, sometimes it happens that this most useful mechanism fails, and it does not concern the whole organism as a whole, but only specific areas of tissues. In this case, a person develops either neurogenic obesity, or lipomas are formed. Stress, sudden hypothermia, frostbite, exposure to radiation, trauma, etc. can provoke such a failure.

• Errors in observing the rules of personal hygiene. Lipomas can form at the site of boils and acne that have not been properly opened. In this case, the pus remains inside, which leads to the formation of a focus of chronic inflammation. The sebaceous glands continue to secrete a thick secretion that can block their lumen. The accumulated sebaceous secretion forms a lipoma. It is covered with a capsule, but the lobules will be absent in it.

It should be noted that all of the above reasons for the formation of lipomas belong to theories. Scientists still do not know for certain what exactly leads to their growth and development.

As diseases that increase the likelihood of a tumor, there are:

• Diseases of the pancreas.
• Liver disease.
• Alcohol abuse.
• Hypothyroidism
• Diabetes.
• The presence of malignant tumors in the upper respiratory tract.
• Lack of pituitary function.

Lipoma symptoms

Lipoma most often does not make itself felt by any specific manifestations. The tumor does not hurt, does not cause discomfort in a person, etc. Therefore, if it is on the internal organs, the patient does not even suspect that he has formed a neoplasm. Naturally, until the lipoma that has grown to an impressive size begins to put pressure on tissues and nerves. Depending on where exactly the tumor has formed, its symptoms will differ.

Symptoms of breast lipoma. Lipomas located in the tissues of the mammary gland have a smooth surface, and lobules are palpable in its capsule. The closer the lipoma is to the surface of the skin, the more it will protrude. At the same time, the breast skin will not have any changes.

If the lipoma is small and located deep in the breast tissue, then it can be detected only by chance, during mammography.

Lipomas of the breast do not hurt and do not cause any physiological discomfort to the woman.

Symptoms of skin lipoma (the tumor is located on the trunk, on the lower or upper limbs, on the face). The lipoma located under the skin is represented by a rounded neoplasm that rises above the surface of the body. It has clear boundaries, regardless of its location.

If you touch the lipoma, you will find that it is mobile, not soldered to the tissues. Lipoma does not respond to pain. After releasing the shifted tumor, it will return to its place.

The surface of the skin, under which the lipoma is located, does not have any pathological changes, it is smooth and even, of a normal color.

Tumors tend to grow, but they grow in size very slowly. It may take a person 5 or sometimes 10 years to notice that the lipoma has become larger. In this case, the size of the neoplasm may not exceed 5 mm, but the formation of a large lipoma of 50 mm or even more is not excluded.

If the tumor is large, then it is able to greatly stretch the skin, hanging on the body like a bag. Sagging skin will serve as a leg. Such lipomas do not receive enough nutrition, so they can become covered with ulcers and undergo necrosis.

Those lipomas on the skin, which are located in places of constant friction with clothes or other parts of the body, are capable of delivering inconvenience. Such tumors will be injured and inflamed all the time. Suppuration is possible, which requires specific treatment.

Large subcutaneous lipomas can put pressure on blood vessels and nerves in nearby muscles and other tissues. This, in turn, disrupts their nutrition, causes pallor of the skin, promotes the formation of ulcers, slows down cell regeneration after injury, etc.

Symptoms of cervical lipoma. Lipoma of the neck has all the symptoms of a subcutaneous lipoma on the trunk: it is soft, painless, mobile. However, it differs from other lipomas in that it is able to constrict the larynx and airways, causing difficulties during breathing and swallowing food. Therefore, doctors strongly recommend removing such neoplasms.

Neck lipomatosis is a disease in which tumors form on the neck, forming a necklace. This disease belongs to genetic pathologies and is inherited.

Symptoms of a lipoma on the kidney. Lipomas on the kidney are formed from the fat capsule of the organ. Such neoplasms are most often small in size and do not manifest themselves in any way. However, as the tumor grows, the following symptoms may join:

• Persistent increase in blood pressure.
• The appearance of pulling pain in the lower back.
• The appearance of blood in the urine.
• The onset of renal colic.
• Varicocele.

When the renal lipoma grows to 5 cm in circumference, the person will be able to palpate it on their own.

Brain lipoma symptoms. If the lipoma of the brain is congenital, then it does not manifest itself in any way. Such tumors do not grow in size and therefore do not require removal.

When a cerebral lipoma develops during life, that is, it is acquired, pathological symptoms may occur. They will begin to appear after the lipoma reaches a large size and begins to press on the internal structures of the brain.

This will be manifested by the following symptoms:

• Chronic headaches.
• Nausea.
• Vomiting.

These symptoms are caused by an increase in intracranial pressure. It should be noted that acquired brain lipomas are rarely diagnosed. Among the group of patients in whom such a tumor still develops, women of 30-50 years prevail.

Symptoms of peritoneal lipoma. The abdominal lipoma is formed in the fatty layer, which is located between the peritoneal leaf and its muscles. The tumor begins to press on the organs when it reaches 5-7 cm in size.

Symptoms of peritoneal lipoma directly depend on which organ is under pressure. So, if it is a stomach, then a person will experience bouts of heartburn, nausea, belching and other digestive disorders.

Lung lipoma symptoms. Until that moment, until the lipoma reaches the pleura, the person will not know about its existence. After this happens, a symptom such as a cough will come to the fore. It appears due to the fact that the tumor irritates the pleura. This process will also be accompanied by pain.

Symptoms of heart lipoma. Lipoma of the heart is manifested by various disorders in the work of the organ, therefore, the patient is diagnosed with arrhythmia. As the tumor grows, the contractility of the heart muscle will decrease, leading to the development of heart failure and pulmonary edema.

Lipoma diagnostics

If a person suspects that he has formed a lipoma, then he needs to contact an oncologist. When there is no opportunity to directly get to this specialist, then first you can visit a therapist and surgeon.

As a rule, the diagnosis of lipoma does not cause difficulties for the doctor. This tumor does not hurt, it slowly increases in size. An additional indirect sign indicating that the patient has a lipoma, and not another tumor, may be an increased blood level of cholesterol and triacylglycerols, as well as LDL. Although sometimes lipomas can form even against the background of normal blood cholesterol levels.

To clarify the structure of the tumor, the patient is prescribed an ultrasound scan. During the study, the doctor determines the exact location of the lipoma, its size, connection with the surrounding tissues and organs.

Lipomas of the internal organs require CT or MRI. Vascular contrasting provides information on how much the tumor is penetrated by blood vessels.

Morphological examination of the tumor is performed after its removal. Since a lipoma is a benign formation, the patient does not receive further treatment. He is recovering from surgery and returning to his normal life.

If during the histological examination it turns out that the tumor was malignant, then the patient will have to undergo a course of radiation therapy and chemotherapy. However, such a neoplasm is no longer called a lipoma.

It is also possible to biopsy the lipoma until it is removed. With the help of this analysis, the doctor is convinced that in front of him is a benign tumor, which does not always require removal.

What is the difference between lipoma and atheroma?

Atheroma is a benign neoplasm that forms as a result of blockage of the sebaceous glands. Atheromas can form only in the upper layers of the skin and always have communication with the external environment.

Atheromas, unlike lipomas, do not reach large sizes, have a dense structure, and are always connected to the skin.

If lipomas are represented by fatty lobules, then atheromas consist of sebum and particles of the epidermis.

Atheromas are capable of festering, as dirt, bacteria, and dust particles can enter the duct through which they communicate with the external environment.

Many people call lipomas and atheromas adipose, although only a lipoma is a lipoma, and an atheroma looks more like a furuncle in structure.

Criterion	Lipoma	Atheroma
Is the tumor inflamed	Very rarely, when rubbing with clothing or other parts of the body	Often inflamed and festering
Is there a communication with the outside	No	Yes, in the form of a duct
Structure	Soft, dense, has lobules	Elastic and elastic
Need to remove	Observation possible	Requires removal
Mobility in relation to the skin	Movable	Not mobile, soldered to the inner surface of the skin
Growth rate	Slow growth	Fast growth
The possibility of growth on internal organs	Yes	No

Is lipoma dangerous?

Although lipoma does not pose a danger in terms of malignancy, nevertheless, it can reduce the patient's quality of life. Thus, a growing tumor does not grow, but pushes the tissues apart, which leads to constriction of blood vessels, disrupts metabolic processes in them. Medicine knows cases when lipomas reached 2 kg in weight and required immediate removal due to the application of strong pressure on adjacent soft tissues.

Large lipomas are also dangerous because their capsules can rupture. If this happens, then the contents of the tumor enters the soft tissues. This process can provoke the development of serious complications. Rarely, but still it happens that the fat contained in the lipoma enters the systemic circulation and leads to embolism.

When lipomas are located around the circumference of the neck, they can lead to breathing and swallowing problems (if they reach large sizes). Sometimes people suffer from asthma attacks, are faced with speech disorders. Large lipomas increase the risk of swelling in the neck tissues. In the future, angina attacks may occur.

A lipoma formed on the neck or armpit can be painful as it is subject to constant pressure. In places where the lipoma comes into contact with clothing, it can macerate, bleed, become inflamed, and ulcerate.

Lipoma on the face or body is a cosmetic defect that prevents many people from wearing the clothes they like, which causes psychological discomfort.

Lipoma treatment

Lipoma treatment is reduced to its surgical removal. It does not dissolve on its own under any circumstances. However, surgery when a lipoma is found is not a prerequisite for its treatment.

There are the following indications for tumor removal:

• Lipoma grows very quickly.
• Lipoma is large.
• Lipoma is located on the pedicle.
• Lipoma was injured.
• Lipoma negatively affects the functioning of adjacent tissues or organs.
• Lipoma is the cause of a cosmetic defect.

If these indications for the operation are absent, then it is up to the patient to remove the lipoma or not.

Methods that are applicable for lipoma removal:

Liposuction. The lipoma removal procedure during liposuction is carried out using a special device called a lipoaspirator. This operation allows you to get rid of the lipoma without leaving visible scars or scars on the skin. An incision is made in an inconspicuous place, into which the doctor inserts a lipoaspirator (a thin tube that creates a vacuum and sucks in the entire contents of the capsule). The vacuum works like a vacuum cleaner. When the tumor is completely removed, the doctor removes the device and sutures a small scar, or simply applies a plaster to the damaged site.

Liposuction is performed with lipomas that are not located in cavities, for example, with lipomas of muscles, tendons, mammary glands, etc. The undoubted advantages of the procedure are: high speed of the operation, no scarring after the intervention, quick rehabilitation period.

As for the shortcomings, there is only one - the lipoma can form again, because it is impossible to remove its capsule during the operation.

Surgical excision of the lipoma. Surgical excision of a lipoma is a radical method to remove the tumor, which ensures that it does not recur. During the procedure, the doctor makes an incision with a scalpel, exposes the lipoma capsule and excises it together with the membrane with scissors. When the growth is removed, a suture is applied to the incision site.

This method has one advantage - it guarantees no lipoma recurrence. However, its disadvantage is its high injury rate. Therefore, surgical excision of a lipoma is prescribed only when the tumor is impressive in size, or is located in hard-to-reach places, which affects the functioning of organs or tissues.

Endoscopic lipoma removal. In this case, the lipoma is removed using a special device called an endoscope. The doctor makes several incisions in the patient's skin through which special tubes are inserted. They are equipped with a camera and scalpel. An image of internal organs and lipoma is displayed on the screen. The doctor with the help of manipulators removes the lipoma, after which he removes the device and applies sutures to the damaged site.

Endoscopic lipoma removal is the best option for getting rid of a tumor located on the internal organs. In this case, the method allows you to get rid of the neoplasm together with the capsule, which guarantees the absence of relapses. In addition, the operation is not associated with pronounced cosmetic defects, since small punctures on the skin become completely invisible over time.

Not all hospitals are equipped with endoscopic equipment, therefore, operations remain inaccessible for a number of people. In addition, endoscopic intervention requires the administration of general anesthesia.

Laser lipoma removal. Removing a lipoma with a laser is a bloodless, safe and low-traumatic method of getting rid of a tumor. However, it can be used only on condition that the neoplasm is localized in the subcutaneous fatty tissue. This is practically the only drawback of the method.

During the procedure, the doctor dissects the tissue with a laser beam, exposes the lipoma capsule, fixes it with forceps and removes it from the tissue. The edges of the incision are tightened with adhesive tape.

Read more: Laser lipoma removal - what and how does it go?

Radio wave lipoma removal. The radio wave method of lipoma removal is used only if the tumor diameter does not exceed 6 cm. The tissues are cut with a radio wave knife (a tungsten filament under tension). The doctor separates the lipoma from the tissues step by step and removes it. The wound is fixed with a suture or with an adhesive plaster. The method is good because it is low-traumatic and does not create a cosmetic defect. In addition, during the procedure, the blood vessels are immediately coagulated, which eliminates the risk of bleeding. However, radio wave removal of a lipoma is limited by the size of the tumor and its location.

Are there folk remedies for lipoma?

• Thuja (white cedar tree) - Thuja helped treat malignant warts caused by HPV, according to a 2013 study. Natural cure proponents believe that it can also be effective for lipoma.
• Boswellia Serrata (Indian Frankincense) - A 2013 review of clinical studies showed Boswellia's good anti-inflammatory effects. Natural healing practitioners suggest that Indian frankincense may also be effective for lipoma.

However, you should understand that there are no studies that would confirm the effectiveness of these drugs for lipoma. No other folk remedies can help you. Do not listen to the recommendations on the use of various lotions and ointments, they can only help with ordinary wen, but not with lipoma.

Should lipoma be removed?

As mentioned, lipoma does not always need to be removed.

There are several absolute indications for the operation:

• The presence of an intracranial lipoma, which puts pressure on the internal structures of the brain.
• The presence of a threat of lipoma rupture into the abdominal cavity or retroperitoneal space.
• Lipoma disrupts the flow of cerebrospinal fluid.
• Lipoma provokes disturbances in the work of the heart.

The patient should seriously consider removing the lipoma in the following cases (relative indications):

• Lipoma puts pressure on the nerves and causes constant pain.
• Lipoma has formed on the liver or kidneys.
• Lipoma is constantly traumatized.
• Lipoma disrupts the normal blood supply to an organ.

Can a lipoma resolve on its own?

By itself, the lipoma cannot dissolve, since it is surrounded by a dense capsule. If a person had a wen, which over time passed on its own, then it was not a lipoma, but another neoplasm. True lipomas do not dissolve.

The author of the article: Volkov Dmitry Sergeevich | c. m. n. surgeon, phlebologist

Education: Moscow State University of Medicine and Dentistry (1996). In 2003 he received a diploma from the Educational and Scientific Medical Center of the Presidential Administration of the Russian Federation.